因侵袭性肝细胞癌和肝胃瘘导致的上消化道大出血。
Massive upper gastrointestinal hemorrhage due to invasive hepatocellular carcinoma and hepato-gastric fistula.
机构信息
Hari Sayana, Osama Yousef, Wendell K Clarkston, Section of Gastroenterology and Hepatology, Department of Internal Medicine, University of Missouri Kansas City, Kansas City, MO 64108-2640, United States.
出版信息
World J Gastroenterol. 2013 Nov 14;19(42):7472-5. doi: 10.3748/wjg.v19.i42.7472.
Abstract
A 36-year-old male Asian immigrant with a history of hepatitis B and hepatitis C related unresectable hepatocellular carcinoma in the left lobe of the liver presented with hematemesis and severe anemia. He was diagnosed with a liver mass that was resected 8 years ago described as a benign tumor in his home country. He had received trans-arterial chemoembolization (TACE) four months ago after subsequent diagnosis of unresectable hepatoma, and currently was receiving chemotherapy with Sorafenib. After resuscitation, a contrast enhanced computerized tomography was performed which showed fistulization of hepatocellular carcinoma into adjacent stomach. This finding was confirmed during endoscopy with direct visualization of the fistulous opening. Hepatocellular carcinoma (HCC) invading the gastrointestinal (GI) tract is rare. We present a case and literature review of HCC with local invasion of the stomach causing massive upper GI bleeding after receiving TACE.
摘要
一位 36 岁的亚裔男性移民，患有乙型肝炎和丙型肝炎相关的不可切除的左叶肝细胞癌。他因呕血和严重贫血就诊。他曾被诊断为 8 年前在其祖国的肝脏肿块，被描述为良性肿瘤，并已接受过肝动脉化疗栓塞术（TACE），四个月前因诊断为不可切除肝癌后又接受了 Sorafenib 化疗。复苏后进行了增强计算机断层扫描，显示肝细胞癌通向相邻胃的瘘管形成。在胃镜检查中通过直接观察瘘口证实了这一发现。肝细胞癌（HCC）侵犯胃肠道（GI）很少见。我们提出了一个病例，并对接受 TACE 后因 HCC 局部侵犯胃导致大量上消化道出血的病例进行了文献复习。
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